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They Lived in a Pandemic Bubble. Now Covid Has Arrived

Surrounded by the sheer expanse of the world’s biggest ocean, many Pacific island nations were among the last parts of the world untouched by Covid-19. Their extreme remoteness worked in their favor, and so did government decisions to slam borders shut early in the pandemic. The Marshall Islands, recognizing the risk of even a single case of Covid, was one of the first countries in the world to close its borders to outsiders in January 2020.  

From Kiribati to Palau and Tonga to the Solomon Islands, this policy has largely worked. “Up until now, they’ve been able to keep Covid at bay largely as a result of closing their borders and being very, very cautious about allowing people to come into the country—including their own people,” says Tess Newton Cain, the project leader of the Pacific Hub at the Griffith Asia Institute, a research center. But shutting borders also meant damaging local economies, which are heavily reliant on tourism. International students were stranded abroad, families were separated, and sailors were stuck overseas while governments called for patience

But such strict border measures were never going to last forever. Two years into the pandemic, some countries have loosened their defenses. Kiribati began to reopen this year, and in late January, a chartered plane was permitted to bring home 54 citizens, many of them missionaries who had been preaching overseas. Some of the Kiribati citizens returning home also brought the virus with them. With that, Kiribati lost its status as one of the last countries without a single case of Covid.

Cases of Omicron in Kiribati now number over 1,700. The nation has been locked down since January 22, with mask mandates, social distancing, and vaccine passes for travel required. The authorities have declared a state of disaster. The health care system is thought to only have a couple of ICU beds, Api Talemaitoga, the head of a network of Indigenous Pacific Island physicians, told the Associated Press. The nation is made up of over 30 atolls spread over a huge area, meaning the remoteness that has kept people safe also means it can take days to receive medical care. Only about a third of Kiribati’s population have been fully vaccinated, according to Our World in Data. 

And after two years of staying Covid-free, Palau reported its first cases in early January, imported by travelers from overseas. The nation’s case count now stands at 460. Schools are closed and a mask mandate is in effect. Health care workers took to Facebook to share the extreme duress they are under: working up to 16 hours a day and sleeping outside so as not to infect their families. 

In the Solomon Islands, cases are soaring. Community transmission of the virus was first confirmed there on January 19. The prime minister, Manasseh Sogavare, said that as of February 6, one in two residents of Honiara, the capital, was infected with Covid-19, making the current case count close to 50,000. The Covid-19 isolation ward in Honiara, the only place designated for positive patients, has just 56 beds. On January 29 the Australian government sent two flights to the country to provide desperately needed medical supplies. Only a fifth of the population is vaccinated, despite a plentiful supply. On social media, locals are sharing photos of huge crowds trying to get vaccinated. There have been 33 Covid-related deaths reported so far. “The Covid-19 situation will get worse before it gets better. Many more of us will get infected and, sadly, many more may lose their lives,” Sogavare said in a national address on February 6.In the aftermath of the recent volcanic eruption and tsunami, Tonga was arguably the most vulnerable of all to an outbreak. On February 1 the government announced that two port workers had tested positive. The number of active cases has since risen to 13, and Tongan authorities have put in place an open-ended lockdown. While 60 percent of the population has been vaccinated, Tongans have not yet received boosters, seeding doubts that they have enough immunity to protect against Omicron. New Zealand has donated 9,300 doses of the Pfizer vaccine to Tonga in an attempt to get them to frontline workers and vulnerable populations quickly.

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It’s hard to overstate the vulnerability of these communities to Covid. Vaccine coverage rates vary wildly in different parts of the region: in Palau, 95 percent of the population is vaccinated; in Papua New Guinea that figure is just 3 percent. It could take five years to vaccinate just a third of its population, one report predicted. Others are more middling but rising: Almost 70 percent of the population is fully vaccinated in Fiji, and around 60 percent in New Caledonia and Samoa. 

A “degree of complacency” can be blamed for low vaccination rates in some countries, says Newton Cain. Little or no experiences with Covid has meant there wasn’t much incentive for the general public to get vaccinated. Distrust of health systems makes vaccine hesitancy a problem too: misinformation spread on social media has fuelled the low vaccine uptake in some countries. 

And to make matters worse, in post-colonial times, food habits have shifted more towards cheap imported processed foods, which, combined with increasingly sedentary lifestyles, has led to a rise in obesity and diabetes, two major risk factors for Covid-19. Almost 60 percent of the adult population of Tonga is thought to be obese. Over 35 percent of the populations of Kiribati, the Solomon Islands, and Vanuatu suffer from nutritional deficiency. “There’s a huge incidence of diabetes in almost every island in Oceania,” says Philippe Georgel, a virology and genetics researcher at the University of Strasbourg who has done research in New Caledonia and co-authored a paper in The Lancet that called for more research into how Covid affects Pacific island nations. 

Health care systems in Pacific island nations are severely limited in terms of equipment, resources, and trained personnel. There are 21 hospital beds and just five physicians for every 10,000 people, according to data from the Asian Development Bank. And social distancing isn’t an option for many. “Often, households are made up of an extended family group,” says Newton Cain—multigenerational and close-knit. “So being able to maintain that social distance is hard.” Lockdowns can also be devastating: Some people don’t have the cash reserves to stock up on necessities in advance, she says. 

As a result, some nations are dealing with a triple burden: the pandemic, the prevalence of non-communicable diseases, and the risk of natural disasters that are common in the region, such as earthquakes and cyclones, says Berlin Kafoa, director for the Public Health Division at the Pacific Community, an international development organization based in New Caledonia, where cases have reached almost 10,000 and the death count is approaching 300. “One natural disaster alone can temporarily wipe out the food security efforts and aspirations of an entire nation,” says Kafoa, which makes these populations “much more susceptible to the complications of Covid-19.”

The first two years of pandemic isolation have also come at a heavy price for the isolated island nations in the Pacific. According to data from the Asian Development Bank, the economies of these countries shrank by almost 6 percent in 2020. The region risks facing a “lost decade” due to the economic fallout unless it receives international aid in the next few years, according to the Lowy Institute, an independent think tank in Sydney, Australia. This has also exacerbated existing social and health vulnerabilities. “It’s now becoming clear that because of the lack of resources generally, and because so many resources have been diverted to Covid, other health challenges are going by the board,” Newton Cain says. “We’re now concerned about a lack of surveillance on things like TB [tuberculosis], or people not being monitored for being pre-diabetic or diabetic, and not being able to get treatments for other things.” The indirect health effects of Covid-19 shutdowns are going to be significant, she warns. 

Now, as they battle outbreaks and climbing case rates, the path out of the pandemic could be treacherous for these countries. “All Pacific island nations will need to reopen to kickstart their already-fragile, contracting economies to improve the livelihoods of their peoples,”says Kafoa. When exactly to reopen will be decided by factors such as vaccination coverage and critical care capacity. His organization’s advice to Pacific island nations is simple: “Assume that they will get Covid-19 and prepare accordingly.” So far, shutting off from the rest of the world has been the only option for these remote countries—and it’s worked. “The problem,” says Georgel, “is it’s not going to work forever.”

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